ENLmedical.com: Conditions And Concerns: Medical Encyclopedia: Necrotizing vasculitis

Necrotizing vasculitis

Causes and Risks:
Necrotizing vasculitis is uncommon, occurring in 6 out of 10,000 people. It may occur in rheumatoid arthritis and is commonly seen with systemic lupus erythematosus , periarteritis nodosa , and progressive systemic sclerosis . It is very rare in children.

The disorder involves inflammation of the lining of the blood vessels. The cause of the inflammation is unknown, but is likely related to autoimmune factors. The tissues become necrotic (dead). The wall of the vessel may scar and thicken. The vessel may close off (occlude), causing lack of blood flow to the tissues supplied by that blood vessel with subsequent infarction (tissue death) of the tissues.

Necrotizing vasculitis may affect any blood vessel of the body, and therefore any part of the body, including the muscles, nerves, kidneys, liver, or any other area.

Prevention:
There is no known way to prevent this disorder.

Symptoms:

skin lesion
- papule
- color red to purple (purpuric)
- on the legs, hands, or other areas
fingers that change color upon pressure (blueness of the fingers or toes)
infarction (inflammation due to lack of oxygen)
- pain in the area
- redness (if superficial area)
- tenderness of the area
joint pain (such as, knee pain , elbow pain )
abdominal pain
pain, numbness , tingling in an extremity or any area
changes or decrease in function of an extremity or any area
fever

Additional symptoms that may be associated with this disease:

Note: Symptoms vary depending on the location of the affected vessels.

Signs and Tests:
Examination findings may vary depending on the part of the body affected by the necrotizing vasculitis. Neurologic examination may show single or multiple neuropathy (nerve damage).

A muscle biopsy of the suspected muscle , nerve biopsy , or organ or tissue biopsy shows vasculitis .
A chest x-ray may indicate lesions of the chest.
A sedimentation rate is often elevated (nonspecific finding).
A urinalysis may show blood, casts , urine protein , or other abnormalities.
Hepatitis blood tests may be positive.

Treatment:
Treatment aims at reduction of the inflammation, allowing the natural healing process to occur. Aspirin or corticosteroids (given in low doses) may reduce inflammation of the blood vessels. (Consult with the health care provider before giving aspirin to children.)

Prognosis:
The outcome varies with the location of the vasculitis and the extent of associated infarction or tissue damage.

Complications:

permanent damage to the structure or function of the affected area
secondary infections of necrotic tissues

Call Your Healthcare Provider:
Call your health care provider if symptoms indicate that necrotizing vasculitis may be present.

Urgent or emergency symptoms include weakness , swallowing difficulty , speech impairment , changes in pupil size, and loss of function of an arm or leg or other body part.

Vasculitis on the thigh: Abnormalities of the blood vessels in the skin can cause many different types of skin rashes such as the one seen here. Inflammation of deeper vessels can cause gangrene/necrosis (tissue death) of the extremities.

One to two centimeter ulcerations are seen here on the lower legs. These may occur as a result of Hepatitis C, inflammation of the blood vessels (vasculitis), or the presence of an abnormal protein (cryoglobulin) in the blood (cryoglobulinemia).